Auditory Processing Disorder Tests
A child with auditory processing disorder (APD) usually passes a standard hearing test. The trouble shows up in a busy classroom: instructions get half-heard, the teacher's voice blurs into the chatter around it, and by the end of the day the child is exhausted from the effort of listening. Dr Signe Steers assesses children and adults for APD at our Forestville and Epping clinics, using a 14-test diagnostic battery scored against age norms.
Auditory processing is what the brain does with what it hears. APD means the ears pick up sound normally, but the brain has difficulty separating, ordering or combining that information, particularly when more than one person is talking.
Early Intervention
Early intervention with APD can help your child significantly in class room situations.
Treatment Options
There are a range of treatment options available that will improve your child's learning and understanding
Independent Clinic
We are an independent clinic, with no ties to corporate entities, which means we can help you in whatever way is needed. We have no bias in treatement.
20 years' experience
Dr Signe has over 20 years experience in treating and managing Auditory Processing Disorders. You are in good hands.
First Appointment
The initial appointment is a full hearing assessment, a comprehensive diagnostic hearing assessment, which is necessary before proceeding with the APD test battery. If hearing loss or middle ear issues are detected, we will need to address these concerns first, and the APD assessments cannot proceed.
Second Appointment
During the second appointment, the audiologist will review the case history and discuss the patient’s listening concerns. The APD test battery will then begin, incorporating a mix of headphone-based tests and live voice assessments.
Signs that point to Auditory Processing Disorder (APD)
- Hearing tests come back normal, but listening in class is hard work
- Instructions need repeating, or only the first part gets done
- Seems not to be paying attention, especially during whole-class teaching
- Copes well one-to-one or at home, and struggles in groups
- Tired or frustrated after school
- Reading, spelling or writing lag behind ability despite support
- Finds it hard to follow one sound while another is playing, such as music with an accompaniment
- A history of ear infections, perforated eardrums or grommets
Children are often referred with ADHD, dyslexia, or a history of speech difficulties. APD can sit alongside any of these. Part of our job is working out which difficulties are auditory, so we test auditory memory separately to rule out a general memory weakness.
How our APD assessment works
Stage 1: Hearing assessment and APD screening [confirm length]. APD can only be diagnosed when hearing itself is normal, otherwise a hearing loss could explain the results. We examine the ear canals, test middle ear function (tympanometry and acoustic reflexes), check inner ear function with otoacoustic emissions, measure hearing from 250 to 8000 Hz, and test speech understanding in quiet and in background noise. If your child has had a recent hearing test elsewhere, bring the results. We will still complete any missing measures before APD testing.
We then screen four areas: auditory closure, temporal processing, dichotic listening and spatial processing. Screening does not diagnose APD. It tells us whether the full battery is warranted. If screening results are normal, we will say so plainly and explain what else might be behind the listening difficulties.
Stage 2: Full diagnostic battery . If screening and history point to APD, we book a second appointment for the full battery described below.
Listening skill | What it means day to day | Tests |
|---|---|---|
Auditory closure and listening in noise | Filling the gaps when speech is muffled, fast or buried in chatter | Auditory Figure-Ground (0, +8 and +12 dB), Filtered Words, Time Compressed Sentences, AudiCloze |
Temporal patterning | Hearing rhythm, stress and intonation, and keeping sounds in the right order | Tap Test, Pitch Pattern, Gap Detection, Duration Pattern |
Binaural separation | Listening to one voice while ignoring another | Competing Sentences |
Binaural integration | Taking in two different messages at once, one in each ear | Competing Words (directed ear and free recall), Dichotic Digits difference test |
Auditory memory | Holding and working with spoken information | Digispan (forward and reverse) |
Spatial processing | Using the direction a voice comes from to pick it out of background talkers | LiSN-S (Listening in Spatialised Noise, Sentences) |
LiSN-S was developed at the National Acoustic Laboratories in Sydney to identify children who struggle to follow speech in the classroom. It is one of the few tests that measures spatial processing directly.
What happens on the day
Testing is done under headphones in a sound-treated room. Each test is explained before it starts, and we build in two listening breaks. Bright children can sometimes guess their way through closure tests using vocabulary and context, so a normal result on those tests is read alongside the history and the other results.
Your report
You receive a written report, and with your consent a copy goes to your GP or referring doctor. It includes:
- a description of each skill tested and what it means in the classroom
- results for each test, with scaled scores, percentiles and 95% confidence intervals
- an ear advantage summary, compared with what is expected for age
- a plain-English interpretation that links the results to the difficulties you described
- recommendations for home, school and exams, and a training plan where one is needed
After a diagnosis: training and support
APD support works on two fronts. Classroom changes reduce the listening load now. Auditory training strengthens the weak skill over time.
For binaural integration difficulties we use Zoocaper Skyscraper, a dichotic listening game played for 10 to 15 minutes a day over about 4 to 6 weeks. For spatial processing disorder we use a training program based on Sound Storm, which also grew out of National Acoustic Laboratories research. We retest after each program to measure the change. Where a remote microphone system would help, we explain how it works and when to consider it.
Working with your child's school
Every report includes practical recommendations for teachers: seating near the teacher and away from doors and corridors, getting your child's attention before giving instructions, checking understanding rather than assuming it, pre-teaching new vocabulary, and flagging transitions between activities. Where results support it, we request exam provisions such as a separate quiet room, extra time, or noise-cancelling headphones for written papers. Dr Steers is happy to speak with your child's school or NESA. Teachers can find more detail in our guide to APD classroom strategies.
APD testing for adults
Adults come to us describing speech that sounds "scrambled" in group conversations, or listening that has become harder work over the years. We run the same hearing assessment, including extended high-frequency testing to 16,000 Hz, followed by APD screening. Sometimes the results show APD. Sometimes they show normal auditory processing, and the report explains how attention, sensory load and fatigue can make complex listening harder. Both answers are useful.